GatewayMD offers a turnkey solution for practices looking to remotely monitor their patients’ chronic conditions, such as hypertension and diabetes. Given the recent acceptance and reimbursement from CMS, the US healthcare market has seen a significant increased adoption rate of remote patient monitoring (RPM) programs.
Although these programs offer clinical and financial value, clinical staffing still poses an issue for many practices and health organizations. For example, one of the RPM CPT codes (99457) requires 20 minutes of clinical staff interaction with each participating patient. Although 99457 is one of the main CPT codes for RPM, it is also the most important when looking at patient acceptance, engagement, and compliance of the program. Without these key elements, the reimbursement for the CPT code regarding data transmission (99454 – “16 days of data transmission in a 30-day period”) is also negatively impacted.
GatewayMD is unique in the space by offering a highly skilled and dedicated clinical staff to their customers. Their staff of experienced nurses and nurse practitioners spend the necessary time and energy with each patient throughout the month, saving precious staff time for the office while increasing patient compliance and engagement.
This case study looks at one of GatewayMD’s partners, Dr Hirani, out of the Houston area and the impact GatewayMD’s clinical staff and managed services has on their compliance rates. Dr Hirani had started her RPM program January of 2021. In May 2021, Dr Hirani had made the transition to GatewayMD’s solution.
Results:
To help understand this case studies results, it is important to define compliance rate. This is the rate at which the overall number of enrolled patients in Dr Hirani’s RPM program completed the CMS billing requirements for CPT codes 99454 (16 days of data transmission) and 99457 (20 min of clinical staff interaction) during a calendar month.
Dr Hirani had operated a “standalone” RPM program for 3 months prior to GatewayMD’s implementation. Dr Hirani’s compliance rate during this period was 26% for CPT code 99454, and 5% for CPT code 99457.
To compare the patient compliance rates before and after GatewayMD’s implementation, the average compliance rates for both CPT codes 99454 and 99457 were divided into the following segments: 1-3 months, 4-6 months, and 7-12 months post GatewayMD implementation. Figures 1.1 and 1.2 illustrate the percent difference in patient compliance rates for CPT codes 99454 and 99457 both before (standalone) and after the implementation of GatewayMD’s clinical staff and managed services.
Within 4 months of implementing GatewayMD’s services, Dr. Hirani’s practice has more than doubled her patient compliance rates pertaining to CPT code 99454. Dr. Hirani’s practice also realized an immediate increase in her patience compliance pertaining to the CPT code 99457 and saw her compliance rate increase from 5% to 96% within a year of implementation.
The increase in patient compliance rates have resulted in significant revenue gains for Dr Hirani’s practice and positive clinical outcomes for her patient’s. By reducing overall workload, Dr Hirani was also able to scale her RPM program to over 200 enrolled patients in a short amount of time.
GatewayMD aims to help practices, such as Dr Hirani’s, scale their RPM program while reducing their overall workload. Dr Hirani leverages the necessary tools, technology, and resources to lift her RPM program to new heights.